AIM: To observe the effects of the combination of positive end expiratory pressure (PEEP) and 80?10 -6 nitric oxide (NO) inhalation on oleic acid induced acute lung injury (ALI) in canine. METHEDS: 30 dogs were divided into 6 groups. Oleic acid was injected through Swan-Ganz catheter to induced ALI. Pulmonary and systemic hemodynamics,blood gas were measured in dogs before and after injection of oleic acid and the period of inhaled NO for 1-6 h. The methemoglobin(MHb) concentrations were measured. Histology and ultrastructure of the lung tissue were observed. RESULTS: (1) The combination of PEEP and 80?10 -6 NO inhalation rapidly reduced mean pulmonary arterial pressure (MPAP) and pulmonary vascular resistance (PVR), increased PaO 2/FiO 2, reduced A-aDO 2 without inducing significant change on systemic hemodynamics. Arterial blood levels of MHb did not change significantly. (2)The combination group was showed the lightest ALI change by HE stain and electron microscopy. CONCLUSION: The combination of PEEP and inhalation of 80?10 -6 NO significantly and rapidly increased PaO 2/FiO 2 without producing lung injury induced by high FiO 2 and high PEEP.

Objective: To understand impacts of past experiences of school bullying victimization and social supports on anxiety symptoms of college students, and to provide basic data for appropriate mental health education. Methods: By using cluster random sampling method, a questionnaire survey was conducted among freshman, sophomore and junior college students majoring in clinical medicine from one medical university in Heilongjiang Province. The questionnaire included general demographic information, school bullying and self-rating anxiety scale. Results: In this survey, 647 students (28.4%) were reported of anxiety symptoms, including 462 (20.3%) with mild anxiety, 162 (7.1%) with moderate anxiety, and 23(1.0%) with severe anxiety. Reported rate of mild, moderate and severe anxiety among college students with bullying victimization experiences during primary school students was 22.8%,33.9% and 59.6%, respectively (χ2=93.05, P<0.05). The figure among students with bullying victimization during junior school was 21.5%, 45.2% and 57.3%, respectively (χ2=186.79, P<0.05). Among those with bullying victimization experiences, anxiety symptoms showed no differences between students with or without social supports from peers, parents and teachers (χ2=7.95, P=0.54; χ2=11.57, P=0.24). Ordinal logistic regression showed bullying victimization during primary school and affection to primary school positively associated with anxiety symptoms among college students, while bullying victimization experiences during junior school showed no association with anxiety symptoms in college. Conclusion Bullying victimization experiences during primary school shows significant association with anxiety symptoms among college students.

Objective: To investigate the prevalence of biting pencils among pupils living in Harbin, Guangzhou, and Beijing and to compare the differences among these cases. Methods: Stratified sampling method was used to select four elementary schools in Harbin and Guangzhou from April 2015 to April 2016. Firstly, Simple random sampling method was used in every grade (grade 1-grade 5) to select 3 or 4 classes (71 classes in total).After the sample selection, questionnaire surveys were conducted among pupils and their guardians (anyone of their guardians) who belonged to these classes. Secondly, the study extracted part of these pupils to conduct a field survey. Every school was classified by grade, and every grade adopted the method of random sampling to select one classes (20 classes in total). Meanwhile, the study randomly selected pupils from 10 classes in 2 elementary schools in Beijing. All together, 1 627 pupils participated in the field survey. The questionnaire included general information about the students and their guardians, the situation of biting pencils, the awareness of the harm of biting pencils, etc.; the field survey considered if participates' pencils have tooth marks and the severity of the marks, etc. χ² was applied to test and compare the differences among pupils of different genders and different cities. The comparison focused on the proportion of students who bited pencils, the proportion of pencils with tooth marks and the proportion of students and guardians already awared of the harm of biting pencils, etc. Results: The number of the valid questionnaires in Harbin and Guangzhou were 1 842, and 1 210, respectively. The occurrence rate of pupils biting pencils in Harbin (18.0% (333/1 842)) was higher than that in Guangzhou (11.3% (137/1 210)) (χ²=29.16, P=0.001). Specifically, in Harbin, the rate of boys biting pencils was 21.9% (212/965), which was higher than girls (13.8% (121/877)) (χ²=27.04, P=0.001). Similarly, in Guangzhou, the rate of boys biting pencils was 14.5% (92/632), which was also higher than girls (7.7% (45/578)) (χ²=15.34, P=0.001). The awareness rate of the harm of biting pencils among students from these two cities were 88.5% (1 611/1 819), and 90.8% (1 098/1 208), respectively, and the difference was statistically significant as well (χ²=4.39, P= 0.020). Compared with these data, the awareness rate of the harm of biting pencils among guardians from these two cities were 74.7% (1 339/1 791), and 79.4% (832/1 047), respectively as well as the statistically significant difference appeared (χ²=9.83, P=0.007). The result of field survey showed the rate of tooth-marked pencils in Harbin, Guangzhou and Beijing was 30.5% (187/613), 14.8% (79/534), and 28.3% (136/480), respectively. The difference was also statistically significant (χ²=42.68, P=0.001). The degree of tooth marks was mainly mild, while the percentage of mild degree in Guangzhou (54.4%(43/79)) and Beijing (41.2% (56/136)) was apparently higher than that of Harbin (39.0% (73/187)). The difference was not statistically significant (χ²=7.01, P=0.136). Conclusion The behavior of biting pencils existed universally among pupils in Harbin, Guangzhou, and Beijing , which the situation of pupils biting pencils in Harbin and Beijing was more serious than that in Guangzhou. Pupils, parents and teachers should pay attention to such a behavior.

Objective To study the clinical characteristics of outpatients with hand,foot and mouth disease (HFMD) caused by different serotypes of enteroviruses.Methods This was a prospective study.From February 2017 to March 2018,563 outpatients with HFMD were enrolled by systematic sampling in the Department of Infectious Diseases,Henan Children's Hospital.Throat swabs were collected to determine the serotypes via PCR.Demographic,clinical,and laboratory data were collected by standard questionnaire.All cases were followed up twice at 2 and 9 weeks after the initial outpatient visit through telephone interview.A total of 563 cases were enrolled and 555 (98.6％) cases were positive for human enteroviruses,including 338 (60.9％) males.Analyses were stratified by enterovirus serotypes,Chi square test or Fisher's exact test,Rank sum test was used for comparison among different groups.Results The age of 555 cases was 24.2 (16.4,41.3) months.Among them 44.0％ (224 cases) were identified as coxsackievirus (CV)-A6,while 189 cases,35 cases,14 cases and 73 cases were identified as CV-A16,enterovirus (EV)-A71,CV-A10 and other serotypes,respectively.Fever (≥37.5 ℃C) was present in 51.4％(285/555) of laboratory confirmed cases.The proportions of fever in cases of CV-A6 (68.9％(168/244)) and CV-A10 (12/14) were significantly higher than those in cases of CV-A16 (31.7％(60/189),x2=57.344,14.313,both P=0.000),other serotypes (43.8％(32/73),x2=15.101 and 8.242,P=0.000 and 0.004) and EV-A71 (37.1％(13/35),x2=13.506 and 9.441,P=0.000 and 0.002) respectively.There was no significant difference between CV-A6 and CV-A10 in presentation of fever (x2=1.785,P=0.182).There were 359 cases (64.7％) with eruptions in mouth,hands,feet and buttocks.Cases infected with EV-A71 had the highest proportions (74.3％(26/35)) of rash emerging simultaneously in mouth,hands,feet,and buttocks.The proportion in cases of CV-A 16,CV-A6,CVA 10 and other serotype were 73.5％ (139/189),61.9％ (151/244),7/14 and 49.3％ (36/73),respectively.The proportion of rash on other parts of body,such as face,limbs or torso in cases infected with CV-A6 (16.8％ (41/244)) was the higherest and the proportion in cases of CV-A16,EV-A71,CV-A10 or other serotypes were 8.5％(16/189),5.7％(2/35),1/14,6.8％(5/73),respectively.None of these cases developed serious complications.Desquamation occurred in 45.5％ (179/393) cases 7.5 (5.0,9.0) days after disease onset and 13.5％ (53/393) cases showed onychomadesis 31.0 (18.0,33.5) days after disease onset.The proportion of desquamation and onychomadesis associated with CV-A6 (64.2％ (95/148) and 31.8％ (47/148)) was significantly higher than CV-A16 (31.8％ (49/154) and 1.3％ (2/154),x2=33.601 and 52.482,both P=0.000) and other serotypes (38.0％(19/50) and 6.0％(3/50),x2=10.236 and 12.988,P=0.001 and 0.000).Desquamation appeared more in cases of CV-A6 than in cases of CV-A10 (2/11,x2=9.386,P=0.002),with the proportion of onychomadesis higher in CV-A6 than in EV-A71 (3.3％ (1/30),x2=11.088,P=0.001).Conclusion Clinical manifestation such as fever,rash emerging parts,desquamation and onychomadesis are different among outpatient HFMD cases infected with CV-A16,CV-A6,EV-A71,CV-A10 and other enteroviruses.

Hydration status refers to the balance between the intake and discharge of water in the body. When the ingested and discharged water are roughly equal and the body is in water balance, it is the normal hydration status, and when the water intake is too little or too much, it is the "dehydration" or "overhydration status". The hydration status of the body not only affects metabolism, but also affects the functions of the urinary system, cardiovascular system, nervous system, etc. In order to further clarify the relationship between body hydration status and decompression sickness (DCS), this paper reviewed relevant studies and analyzed the interaction between hydration and decompression safety during diving. The primary causes of dehydration in diving are "hyperbaric diuresis", "immersion diuresis", breathing dry gas, heat, and cold. Dehydration not only promotes the occurrence of DCS but also reduces the aerobic work efficiency and athletic performance of divers, as well as affects cognition and mood. A study found that appropriate rehydration before and during diving can reduce the risk of DCS, which possibly associates with the increase of blood volume, plasma surface tension, and vasoconstriction. Fluid therapy is also important for those who already have DCS. This paper analyzed the amount, nature, timing, and effect of rehydration involved in the above links, comprehensively sorted out the relationship between hydration and diving safety, summarized the existing problems, and provided reference for practical application and future research.